HomeMy WebLinkAbout26-4615 a ITFFi "OLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 5 27c
COLLISION REP FIT 1591971
CASE 26-4615 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2� TOTAL#OF OBJECT 1 �2$
TRIBAL UNITS 01 STRUCK
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION'. 06 - 1-— 2026 2146 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
156TH AVE SE BLOCK NO. e✓ 12923
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4254447716 30
6� LAST NAME MINKIEWITZ FIRSTNAME TERRY MIDDLE M 1 1 2 31
INITIAL
STREET ❑, 19630 SE 149TH ST CITY RENTON ST WA ZIP 98059 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ PI ATFBit AYA2501 sTAr� WA VIN#' JTHBK1 GG4F2209877
TRAILER STATE TRAILED STATE
11 3 5 PLATE# PLATE# Rom To
TRLR. TRLR 5 5
2❑ 33
1 VIN#' VIN#'
FR.. 34
13� VEH.YEAR2015 MAKE LEXS MODEL ES350 STYLE $D VEHICLE TOWEDNOOpLSABLIN TSIYYEp9vMEYERS vOs❑ENo�
HICLE
DAMAGE IILLJJII (��IV6
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
❑ SHADE IN DAMAGED AREA ❑ 35
14 LIABILIT INSURANCE❑ INSURANCE CO UNKNOWN-
IN EFFECT &POLICY#
ve'C ❑ 36
LEGALLv res❑NO❑ CITATION# CHARGE BOTTOM
15❑ NDING
�UITN 02 VE ICCLE ❑ CYCLE ❑ PEDESTRIAN ❑ OWNERMOTO YES
❑ DYES NO OLD MET PHONE
16❑
LAST NAME FIRST NAME MIDDLEITIAL
IN
STREET
CITY' ST ZIP 4❑ 37
17❑ NEW ADDRES7
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LLIICENS # STATE SEX MMDDYY —�_ 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ TArE 41
IN#LICENSE V 1
PLATE#
42
22 [TRAILER T
❑ PLATE# STATE PLATE#ILER STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE❑ INSURANCE
#E CO
IN EFFECT &PO I VE—LE ❑ ,J� CITATION# CHARGE
25 GQ
LEGALLY YES N`L J
s � e
=TURNER
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26 12650 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. EH13533
COLLISION REPORT III III III III III 111
1591972 CASE# 26-4615
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) MINKIEWITZ MARYE
(LAST FIRST,
ADDRESS&PHONE#
19630 SE 149TH ST RENTON WA 98059 4254447716 SEXi F MMDDYyry 09 - 08 - 1939
PASSENGER Z WITNESS i UNIT# ( 1 POS 13 AIRBAG!2 RESTR. 4 EJECT ? 1 HELMET NATURE OF INJURIES
USE 2 CLASS
1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# Ly O B
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.
MMDDYYYY. -
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
Unit 1 was traveling southbound in the 12900 block of 156th Ave SE. Unit 1 reported that he was
attempting to change his glasses, as he was changing his glasses he veered off the roadway towards
the eastern part of the intersection. The vehicle briefly continued driving off the roadway until
reaching a large ditch on the side of the roadway, the vehicle's passenger tires got caught in the ditch
causing the vehicle to slide down the roadway and flip onto it's trunk.
Both the driver and passenger of Unit 1 were not injured and no other vehicles or property were
involved. Unit 1 had substantial damage all over the vehicle and required a tow to be removed from
the ditch and was no longer operable.
I find that the proximate cause of the collision was Unit 1 being distracted while attempting to grab his
glasses. The distracted driving caused the vehicle to veer off the roadway.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct. Electronically signed by J. Turner 12650 on 06/14/2026 at 1955 hours
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
JASON TURNER 06-14-26 07:55 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
QUINT TIBEAU 7691 1 6/18/2026 11:59:18 PM
BADGE OR ID# ( 12650 ORI#' WA0171300 TIME POLICE DISPATCHED! 9:46 PM TIME POLICE ARRIVED',9:50 PM
FART I PAGE IT]OF 3�
REPORT NO.! EH13533 CASE# 26-4615 DATE AND TIME 06/13/26 21:46
OF COLLISION
y� 3
al
Pik
F
4
01
o ti4
PAGE 3 OF 3